* Mayor's Presence Requested at Presentation: (If yes, please refer to the Mayor's Event Request Form and submit with this request)

Yes
No

* Full name, address, telephone numbers, and e-mail address of person(s) or organization receiving the proclamation or certificate:

* Full name, address, telephone numbers, e-mail address of person(s) or organization, and relationship to recipient(s) of the person requesting the proclamation or certificate:

* Please include a draft of your proclamation/citation:

Due to the volume of requests received and the time needed to prepare proclamations or certificates, all requests must be submitted 6 weeks in advance and include all background information and other supporting materials necessary for the proclamation or certificate to be written.